Coarctation of the aorta of unusual morphology.

Three unusual types of coarctation of the aorta are presented together with long-term follow up covering a period of 8-12 years, after successful operative reconstruction. In one case there were two constrictive lesions, one proximal to the left subclavian artery and the other at the typical location, while in another the coarctation was located between two common carotids, with associated congenital hypoplasia of the left subclavian artery, resulting in a steal syndrome. In the last case, there was evidence of a supradiaphragmatic coarctation. In all cases surgical reconstruction was accomplished by means of a Dacron graft. Even unusually located coarctations are highly likely where physical examination reveals, either in one or both limbs hypertension with concomitant weakness of femoral pulsations. However aortography is mandatory for adequate delineation of the disease and precise surgical orientation. All three patients live a normal life today.